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Scuracchio P, Achkar R, Dias L, Oliveira M, Casella I, Presti C, Fachini R, Wendel S. A rare vascular injury in a blood donor after whole blood donation. Transfusion 2024; 64:546-549. [PMID: 38230511 DOI: 10.1111/trf.17725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/10/2023] [Accepted: 12/14/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Blood donation is a safe process though reactions may still occur. We describe a rare vascular complication in a frequent donor, with improvements in the collection process aimed at avoiding future events. METHODS A 63-year-old woman presented with local pain and an apparent collection in the left arm 8 days after donation. Duplex ultrasound identified a superficial liquid collection and signs of arteriovenous fistula (AVF) between the cubital vein and an arterial branch. A computed tomography (CT)-angio performed 1 day after ultrasound did not identify signs of AVF, followed by a new duplex which confirmed CT-angio findings. It was assumed that a traumatic AVF evolved with spontaneous thrombosis. In the early follow-up (18 days), a progressive regression of hematoma was observed without any sequelae. RESULTS Investigation showed a faster whole blood bag collection time (3 min; normal: 5-9 min), and the processed packed red blood cell had a brighter red color than usual. The donor reported local bleeding after needle withdrawal, not observed in previous donations and a bruise forming on the same day. No arterial puncture (AP) was noticed by the collection staff during the procedure. The staff was retrained and actions were taken focusing on more active surveillance of late reactions, highlighting the importance of post-donation information by the donors, regardless of any adverse reaction observed, to detect late complications. CONCLUSION We described an uncommon AP in a donor that was not identified, leading to an AVF that spontaneously thrombosed.
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Affiliation(s)
| | - Ruth Achkar
- Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil
| | - Lara Dias
- Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil
| | | | - Ivan Casella
- Universidade de São Paulo-Hospital das Clínicas, São Paulo, Brazil
| | - Calogero Presti
- Universidade de São Paulo-Hospital das Clínicas, São Paulo, Brazil
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Achkar R, Erdens M, Scuracchio P, Dias L, Oliveira AS, Souza LF, Acciari TMS, Silva AG, Fachini R, Wendel S. DOIS PACIENTES COM SÍNDROME DE GUILLIAN-BARRÉ APÓS INFECÇÃO POR SARS-COV-2. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Fontão-Wendel R, Dias L, Achkar R, Scuracchio P, Souto R, Farias C, Pagani FM, Brito MA, Fachini R, Wendel S. MANEJO DE PACIENTES COM REFRATARIEDADE PLAQUETÁRIA: 20 ANOS DE EXPERIÊNCIA. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Fachini RM, Fontão-Wendel R, Scuracchio P, Achkar R, Miyaji S, Erdens M, Brito M, Amaral M, Wendel S. REDUÇÃO SIGNIFICATIVA NAS TAXAS DE DESCARTE POR VENCIMENTO DAS PLAQUETAS TRATADAS PARA REDUÇÃO DE PATÓGENOS (INTERCEPT) DEVIDO À EXTENSÃO DO PERÍODO DE ARMAZENAGEM ATÉ 7 DIAS. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Wendel S, Fontão‐Wendel R, Fachini R, Candelaria G, Scuracchio P, Achkar R, Brito M, Reis LF, Camargo A, Amano M, Machado R, Araujo D, Soares C, Durigon E. A longitudinal study of convalescent plasma (CCP) donors and correlation of ABO group, initial neutralizing antibodies (nAb), and body mass index (BMI) with nAb and anti-nucleocapsid (NP) SARS-CoV-2 antibody kinetics: Proposals for better quality of CCP collections. Transfusion 2021; 61:1447-1460. [PMID: 33604884 PMCID: PMC8013380 DOI: 10.1111/trf.16323] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/29/2020] [Accepted: 01/20/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Little is known about the neutralizing (nAb) and binding antibody kinetics in COVID-19 convalescent plasma donors, especially during the first 100 days after disease onset. MATERIALS AND METHODS A cohort of previously RT-PCR positive (detected by nasopharyngeal swab during the acute phase), male convalescent patients, all with mild symptoms, were enrolled in serial blood sample collection for a longitudinal nAb titers and anti-nucleocapsid (NP) antibodies (IgM, IgG and IgA) evaluation. NAbs were detected by a cytopathic effect-based virus neutralization test (CPE-based VNT), carried out with SARS-CoV-2 (GenBank: MT350282). RESULTS A total of 78 male volunteers provided 316 samples, spanning a total of 4820 days of study. Although only 25% of donors kept nAb titers ≥160 within 100 days after the onset of disease, there was >75% probability of sustaining nAb titers ≥160 in volunteers whose initial nAb titer was ≥1280, weight ≥ 90 kg or obese, according to their body mass index (BMI), as evidenced by Kaplan-Meier analysis and Cox hazard regression (all p < .02). There was no correlation between the ABO group, ABO antibody titers and persistent high nAb titers. High IgG anti-NP (S/CO ≥5.0) is a good surrogate for detecting nAb ≥ 160, defined by the ROC curve (sensitivity = 90.5%; CI95%: 84.5%-94.7%). CONCLUSION Selection of CCP donors for multiple collections based on initial high nAb titers (≥1280) or BMI ≥ 30 kg/m2 provides a simple strategy to achieve higher quality in CCP programs. High IgG anti-NP levels can also be used as surrogate markers for high nAb screening.
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Affiliation(s)
| | | | | | | | | | - Ruth Achkar
- Hospital Sírio‐Libanês Blood BankSão PauloBrazil
| | - Mayra Brito
- Hospital Sírio‐Libanês Blood BankSão PauloBrazil
| | | | | | | | - Rafael Machado
- Departamento de MicrobiologiaInstituto de Ciências Biomédicas, USPSão PauloBrazil
| | - Danielle Araujo
- Departamento de MicrobiologiaInstituto de Ciências Biomédicas, USPSão PauloBrazil
- Hospital Israelita Albert EinsteinSão PauloBrazil
| | - Camila Soares
- Departamento de MicrobiologiaInstituto de Ciências Biomédicas, USPSão PauloBrazil
| | - Edison Durigon
- Departamento de MicrobiologiaInstituto de Ciências Biomédicas, USPSão PauloBrazil
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Wendel S, Kutner JM, Machado R, Fontão‐Wendel R, Bub C, Fachini R, Yokoyama A, Candelaria G, Sakashita A, Achkar R, Hamerschlak N, Scuracchio P, Amaral M, Dal Ben M, Araujo D, Soares C, Camargo A, Kallás E, Durigon E, Reis LF, Rizzo LV. Screening for SARS-CoV-2 antibodies in convalescent plasma in Brazil: Preliminary lessons from a voluntary convalescent donor program. Transfusion 2020; 60:2938-2951. [PMID: 32935877 PMCID: PMC7756544 DOI: 10.1111/trf.16065] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/02/2020] [Accepted: 08/02/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) collection began in two Brazilian hospitals for treatment of severe/critical patients. METHODS AND MATERIALS Mild/moderate COVID-19 convalescents were selected as CCP donors after reverse transcription polymerase chain reaction (RT-PCR) confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and absence of symptoms for ≥14 days plus (a) age (18-60 years), body weight greater than 55 kg; (b) immunohematological studies; (c) no infectious markers of hepatitis B virus, hepatitis C virus, human immunodeficiency virus, human T-lymphotropic virus-1/2, Chagas and syphilis infection; (d) no HLA antibodies (multiparous); (e) second RT-PCR (nasopharyngeal swab and/or blood) negativity; (f) virus neutralization test (cytopathic effect-based virus neutralization test neutralizing antibody) and anti-nucleocapsid protein SARS-CoV-2 IgM, IgG, and IgA enzyme-linked immunosorbent assays. RESULTS Among 271 donors (41 females, 230 males), 250 presented with neutralizing antibodies. Final RT-PCR was negative on swab (77.0%) or blood (88.4%; P = .46). Final definition of RT-PCR was only defined at more than 28 days after full recovery in 59 of 174 (33.9%) RT-PCR -ve, and 25/69 RT-PCR +ve (36.2%; 13 between 35 and 48 days). Neutralizing antibody titers of 160 or greater were found in 63.6%. Correlation between IgG signal/cutoff of 5.0 or greater and neutralizing antibody of 160 or greater was 82.4%. Combination of final RT-PCR -ve with neutralizing antibody ≥160 was 41.3% (112/271). Serial plasma collection showed decline in neutralizing antibody titers and IgA levels (P < .05), probably denoting a "golden period" for CCP collection (≤28 days after joining the program); IgA might have an important role as neutralizing antibody. Donor's weight, days between disease onset and serial plasma collection, and IgG and IgM levels are important predictors for neutralizing antibody titer. CONCLUSIONS RT-PCR +ve cases are still detected in 36.2% within 28 to 48 days after recovery. High anti-nucleocapsid protein IgG levels may be used as a surrogate marker to neutralizing antibody.
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Affiliation(s)
| | | | - Rafael Machado
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | | | - Carolina Bub
- Hospital Israelita Albert Einstein Blood BankSão PauloBrazil
| | | | - Ana Yokoyama
- Hospital Israelita Albert Einstein Blood BankSão PauloBrazil
| | | | - Araci Sakashita
- Hospital Israelita Albert Einstein Blood BankSão PauloBrazil
| | - Ruth Achkar
- Hospital Sírio‐Libanês Blood BankSão PauloBrazil
| | | | | | | | | | - Danielle Araujo
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | - Camila Soares
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | | | - Esper Kallás
- Infectious Disease DepartmentUniversity of São Paulo Medical SchoolSão PauloBrazil
| | - Edison Durigon
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | | | - Luiz Vicente Rizzo
- Albert Einstein Jewish Institute for Education and ResearchSão PauloBrazil
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Abstract
We propose systems that allow a tuning of the phonon transmission function T(ω) in graphene nanoribbons by using C(13) isotope barriers, antidot structures, and distinct boundary conditions. Phonon modes are obtained by an interatomic fifth-nearest neighbor force-constant model (5NNFCM) and T(ω) is calculated using the non-equilibrium Green's function formalism. We show that by imposing partial fixed boundary conditions it is possible to restrict contributions of the in-plane phonon modes to T(ω) at low energy. On the contrary, the transmission functions of out-of-plane phonon modes can be diminished by proper antidot or isotope arrangements. In particular, we show that a periodic array of them leads to sharp dips in the transmission function at certain frequencies [Formula: see text] which can be pre-defined as desired by controlling their relative distance and size. With this, we demonstrated that by adequate engineering it is possible to govern the magnitude of the ballistic transmission functions [Formula: see text] in graphene nanoribbons. We discuss the implications of these results in the design of controlled thermal transport at the nanoscale as well as in the enhancement of thermo-electric features of graphene-based materials.
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Affiliation(s)
- P Scuracchio
- Facultad de Ciencias Exactas Ingeniería y Agrimensura, Universidad Nacional de Rosario, Av. Pellegrini 250, S2000BTP Rosario, Argentina. Instituto de Física Rosario, Bv. 27 de Febrero 210 bis, S2000EZO Rosario, Argentina
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van der Meer PF, Reesink HW, Panzer S, Wong J, Ismay S, Keller A, Pink J, Buchta C, Compernolle V, Wendel S, Biagini S, Scuracchio P, Thibault L, Germain M, Georgsen J, Bégué S, Dernis D, Raspollini E, Villa S, Rebulla P, Takanashi M, de Korte D, Lozano M, Cid J, Gulliksson H, Cardigan R, Tooke C, Fung MK, Luban NLC, Vassallo R, Benjamin R. Should DEHP be eliminated in blood bags? Vox Sang 2013; 106:176-95. [DOI: 10.1111/vox.12099] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Scuracchio P, Vieira SD, Dourado DA, Bueno LM, Colella R, Ramos-Sanchez EM, Lima GFMC, Inoue J, Sanchez MCA, Di Santi SM. Transfusion-transmitted malaria: case report of asymptomatic donor harboring Plasmodium malariae. Rev Inst Med Trop Sao Paulo 2011; 53:55-9. [DOI: 10.1590/s0036-46652011000100010] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Accepted: 12/06/2010] [Indexed: 11/22/2022] Open
Abstract
Malaria in Brazil is endemic in the Amazon region, but autochthonous cases with low parasitaemia occur in the Atlantic Forest area of the country. According to Brazilian legislation no test is mandatory for blood donors from non-endemic areas. However if they have traveled to malaria transmission regions they are deferred for six months before they can donate. This report describes a transfusion-transmitted malaria case in Sao Paulo, Brazil, where one recipient received infected blood and developed the disease. He lived in Sao Paulo and had no previous transfusion or trips to endemic areas, including those of low endemicity, such as Atlantic Forest. Thick blood smears confirmed Plasmodiummalariae. All donors lived in Sao Paulo and one of them (Donor 045-0) showed positive hemoscopy and PCR. This asymptomatic donor had traveled to Juquia, in the Atlantic Forest area of S ao Paulo State, where sporadic cases of autochthonous malaria are described. DNA assay revealed P. malariae in the donor's (Donor 045-0) blood. Serum archives of the recipient and of all blood donors were analyzed by ELISA using both P. vivax and P. falciparum antigens, and IFAT with P. malariae. Donor 045-0's serum was P. malariae IFAT positive and the P. vivax ELISA was reactive. In addition, two out of 44 donors' archive sera were also P. vivax ELISA reactive. All sera were P. falciparum ELISA negative. This case suggests the need of reviewing donor selection criteria and deferral strategies to prevent possible cases of transfusion-transmitted malaria.
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